State RegulationsNJ specificDifficulty 2/5
New Jersey's prompt-pay deadlines for health claims are set at N.J.S.A. 26:2J-8.1d and implemented through which administrative rules?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
The prompt-pay deadlines of N.J.S.A. 26:2J-8.1d are implemented through N.J.A.C. 11:22-1.5 and N.J.A.C. 11:22-1.6, the administrative rules that operationalize the electronic and paper clean-claim windows in New Jersey. The New Jersey Department of Banking and Insurance adopted and enforces these rules, and they are cited in the department's own market-conduct materials as the operative prompt-pay regulations.
Why the other options are wrong
- A) N.J.A.C. 11:2-22 belongs to a different regulatory family and does not implement the prompt-pay deadlines.
- B) N.J.A.C. 11:4-16.6 governs individual health policy minimum standards such as the free-look period, not claim-payment deadlines.
- C) N.J.A.C. 11:2-17.1 implements the unfair claim settlement practices framework, a broader claims-conduct regime distinct from the prompt-pay rules.
Memory hook
Prompt pay lives in 11:22 — 1.5 and 1.6 carry the clock.